Denervated or Innervated Flaps for the Lower Lip Reconstruction? Are They Really Different to Get a Good Result?

Abstract

B-2b.

Functional lower lip reconstruction with the modified Bernard–Webster flap

“…These neurosensory deficits were completely resolved in the late postoperative period, and no permanent neurosensory deficit was evidenced, as previously highlighted, that neurosensitivity can slowly return in patients with a reconstructed lower lip 23 . Thus, our primary hypothesis has proven to be right.…”

“…The standardized clinical examination consisted of an evaluation of the orbicular ring function including: opening the mouth, pouting the lips, lip at rest for lip continence, speech, and neurosensitivity according to similar previous investigations 8, [20][21]23 . Oral continence (incompetence, sialorrhoea at rest, sialorrhoea formed with fluid intake, and complete competence) and lip mobility (symmetric/asymmetric by observing pouting and mouth-opening movements) were verified according to a previous study 21 .…”

“…The permanent neurosensory deficit was defined as "abnormal clinical test" with at least 12 months postoperatively 24,25 . All patients were questioned about their overall satisfaction (satisfied, partially satisfied, or dissatisfied) with the late functional results 23 .…”

Double‐paddle peroneal flap for extensive lip defect reconstruction

“…For lip reconstruction using free tissue transfer, radial forearm free flap has been the workhorse. After years of refinement, lip reconstruction using radial forearm flaps has achieved a certain degree of sensory (Civelek, Celebioglu, Unlu, Civelek, Inal, & Velidedeoglu, ; Özdemir, Ortak, Koçer, Çelebioglu, Sensöz, & Tiftikcioglu, ) and motor recovery (Gurunluoglu, Glasgow, Williams, Gurunluoglu, Antrobus, & Eusterman, ; Kushima, Iwasawa, Kiyono, Ohtsuka, & Hataya, ; Ninkovic et al, ; Shinohara, Iwasawa, Kitazawa, & Kushima, ), in addition to simply fixing the defects. Peroneal flap, a boneless variant of the commonly used fibula flap first introduced by Yoshimura, Imura, Shimamura, Yamauchi, & Nomura (), has been a workhorse for head and neck reconstruction in our institution since 1996 (Huang, Liu, Chen, & Yang, ; Liu & Yang, ; Lin, Liu, Chen, & Yang, ; Yang et al, ).…”

“…It is reasonable to think that inclusion of the adjacent sural nerve during harvest could also be used to provide sensation for the newly reconstructed lip. However, according to a study on lower lip reconstruction by Civelek et al (), the denervated flap group had no functional inferiority to the innervated flap group. The authors believe that neurotization could occur from adjacent tissues, facilitating functional recovery to acceptable levels.…”